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Organization

GENTLE CARE LIVING CENTER

Active
Parent organization
N/A
Organization subpart
Yes

Provider details

NPI number
Legal business name
N/A
Authorized official
MS. VANAVIA NAOMI RICHARDSON N/A (DIRECTOR)
(832) 775-5203
Entity
Organization

Contact information

Practice address
12660 MEDFIELD DR, STE.418, HOUSTON, TX 77082-5432
(832) 775-5203
(832) 775-5204
Mailing address
2801 WALNUT BEND LN, STE.68, HOUSTON, TX 77042-3464
(832) 775-5203
(832) 775-5204

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
3748
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
029093410
TX
05
189407301
TX
05
205602001
TX
Enumeration date
10/28/2010
Last updated
10/28/2010
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